Sodium valproate is used in all types of seizures except:

Correct Answer: B

Rationale: In pediatric nursing, understanding the appropriate use of medications like sodium valproate in managing seizures is crucial. The correct answer, B) Infantile spasms, is not typically treated with sodium valproate due to its limited efficacy for this specific seizure type. Infantile spasms often require other medications or interventions for better control. Option A) Absences seizures are commonly managed with sodium valproate as it is effective for this type of seizure. Option C) Generalised clonic seizures and Option D) Myoclonic seizures also respond well to sodium valproate in many cases, making them inappropriate choices for the exception. Educationally, this question highlights the importance of understanding the nuances of pharmacological interventions in pediatric patients with seizures. It reinforces the need for nurses to be familiar with the specific indications and contraindications of medications like sodium valproate to provide safe and effective care to pediatric patients with varying seizure types.

Correct Answer: D

Rationale: In pediatric nursing, understanding the manifestations of infective endocarditis is crucial for early identification and appropriate management. The correct answer is D) Roth spots. Roth spots are retinal hemorrhages with pale centers that are indicative of systemic emboli, commonly seen in infective endocarditis due to bacterial vegetation breaking off and traveling to the eyes. Option A) Intracranial hemorrhage is not typically associated with infective endocarditis in children. It may be seen in conditions like trauma or bleeding disorders. Option B) Conjunctival hemorrhages are not specific to infective endocarditis and can be seen in various conditions, including trauma or systemic diseases affecting coagulation. Option C) Glomerulonephritis is not a typical finding in infective endocarditis. It can occur as a complication of certain infections, but it is not a characteristic feature of infective endocarditis. Educationally, understanding the signs and symptoms of infective endocarditis in pediatric patients is essential for nurses to provide timely care. Teaching about specific physical examination findings like Roth spots can aid in early recognition and prompt referral for diagnosis and treatment, ultimately improving patient outcomes. Nurses should be well-versed in the differential diagnosis of symptoms to ensure accurate assessment and intervention in pediatric cardiovascular cases.

Correct Answer: D

Rationale: The correct answer is D) All of the above. After the repair of coarctation of the aorta in an infant, there are several long-term complications that can occur. Persistent systemic hypertension is a common complication due to the changes in vascular structure and function that may persist even after surgical correction. This can lead to increased workload on the heart and potential for future cardiovascular issues. Re-coarctation refers to the recurrence of the narrowing of the aorta at the site of the original repair. This can happen due to scarring or tissue growth at the surgical site, leading to a repeat of the condition. Berry aneurysms are another potential complication, particularly in patients with underlying connective tissue disorders. These aneurysms are weak, bulging areas in the walls of blood vessels that can rupture and cause serious complications like hemorrhage or stroke. It is important for pediatric nurses to be aware of these long-term complications associated with the repair of coarctation of the aorta, as early identification and management can help prevent serious health issues in these patients as they grow older. Regular follow-up assessments, monitoring of blood pressure, and educating families on signs and symptoms to watch for are crucial aspects of care for these patients.

Correct Answer: D

Rationale: In pediatric patients with biatrial enlargement, a combination of medical management plans is often necessary to address the underlying cardiac condition effectively. The correct answer, option D (All of the above), is the most comprehensive approach to managing biatrial enlargement in children. Loop diuretics, such as furosemide, are used to reduce fluid retention and alleviate symptoms of volume overload in the heart. They help decrease preload on the heart, which can be beneficial in cases of atrial enlargement. Beta-blockers, like metoprolol, are used to slow down the heart rate and reduce the workload on the heart. They are particularly useful in conditions where there is atrial enlargement to prevent arrhythmias and improve cardiac function. Anticoagulation therapy is crucial in cases of atrial enlargement to prevent the formation of blood clots in the enlarged atria, which can lead to serious complications like stroke. Medications like warfarin or direct oral anticoagulants (DOACs) are commonly prescribed in these situations. Option A (Loop diuretics) and option B (Beta-blockers) are correct choices as part of the multifaceted approach to managing biatrial enlargement. However, option C (Anticoagulation) is equally important and should not be overlooked in pediatric patients with cardiac conditions predisposing them to clot formation. Educationally, understanding the rationale behind each medical management plan is crucial for nurses caring for pediatric patients with cardiovascular conditions. By comprehensively addressing volume overload, heart rate control, and clot prevention, healthcare providers can optimize outcomes and improve the quality of life for these children.

Correct Answer: D

Rationale: In repaired Tetralogy of Fallot, which is a congenital heart defect, three long-term complications include arrhythmia, pulmonary valve insufficiency, and recurrent pulmonary stenosis (PS). The correct answer, option D, "Recurrent PS," is the most likely long-term complication in repaired Tetralogy of Fallot. This is because despite surgical repair, patients often experience narrowing of the pulmonary valve over time, leading to recurrent PS. Option A, "Arrhythmia," is a possible complication as well, but it is more commonly associated with other congenital heart defects or acquired heart conditions. Pulmonary valve insufficiency, option B, can occur but is not as prevalent a long-term complication as recurrent PS in repaired Tetralogy of Fallot. Option C, "Sudden Death," is not a typical long-term complication of repaired Tetralogy of Fallot. While individuals with this condition may be at risk for sudden death if complications arise, it is not one of the expected long-term sequelae. From an educational perspective, understanding the long-term complications of repaired Tetralogy of Fallot is essential for pediatric nurses caring for these patients. Recognizing these complications can help nurses provide appropriate monitoring, interventions, and education to promote the best outcomes for these individuals as they transition into adulthood.